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Updated: Jul 16, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
[Selection of statin considering the HDL cholesterol level]
1MAV Kórház és Központi Rendelointézet, Kardiológia, Budapest. kalinaak@t-online.hu
Insights
Low high-density lipoprotein (HDL) cholesterol is a risk factor for cardiovascular disease. Simvastatin effectively increases HDL cholesterol levels more than atorvastatin, aiding therapeutic goals in high-risk patients.
Area of Science:
- Cardiology
- Pharmacology
- Metabolic Disorders
Background:
- Low high-density lipoprotein (HDL) cholesterol is an independent risk factor for cardiovascular diseases (CVD).
- Therapeutic strategies aim to increase HDL cholesterol levels, particularly in high-risk populations such as those with CVD, diabetes, or metabolic syndrome.
- Target HDL cholesterol levels are >1.0 mmol/l for males and >1.3 mmol/l for females in high-risk individuals.
Purpose of the Study:
- To compare the efficacy of simvastatin versus atorvastatin in increasing HDL cholesterol levels.
- To highlight the importance of optimizing HDL cholesterol alongside LDL cholesterol targets in patient therapy.
Main Methods:
- Review of clinical trials and pharmacological data on statin effects on HDL cholesterol metabolism.
- Analysis of the role of Peroxisome Proliferator-Activated Receptor alpha (PPARα) in HDL cholesterol regulation.
Main Results:
- Simvastatin demonstrated a superior effect in increasing HDL cholesterol levels compared to atorvastatin.
- Both fibrates and statins influence HDL cholesterol metabolism via PPARα receptor activity.
- Clinical trials support the positive effect of simvastatin on HDL cholesterol.
Conclusions:
- Simvastatin is a more effective option than atorvastatin for improving HDL cholesterol levels.
- Optimizing HDL cholesterol is a crucial component of cardiovascular risk management, complementing LDL cholesterol goal achievement.
Abstract:
Low HDL cholesterol level is an independent risk factor in the cardivascular diseases and the therapeutic aim is to increase this. In high risk patients (cardiovascular disease-, diabetic- or metabolic syndrome patients), the target value of HDL cholesterol is more than 1,0 mmol/l in males and 1,3 mmol/l in females. The PPARalpha receptor activity has an expressed impact on the HDL cholesterol metabolism. It has been proved that in addition to fibrates, statins also influence its functioning. Simvastatin, as compared to atorvastatin, increases the HDL cholesterol level in a better way which positive effect has also been proved by the clinical trials. On choosing a therapy the optimisation of the HDL cholesterol level is also important in addition to achieving an LDL cholesterol target value.
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